Can You Really Get Patients to Exercise?

It’s Monday morning and your provider is already 15 minutes behind schedule. She is hoping she might be able to expedite this visit in a way that’s still in line with the “We care about you” motto of the clinic. As luck may have it, the next patient is Mrs. Jones, here to follow up on a visit three months ago when she was worried about her Type II Diabetes. Your provider’s advice was to make exercise a part of her life. She shared with Mrs. Jones the advantages of exercise and how it is able to help with depression and has the same physical benefits as many of the medications on the market. As your provider is about to open the door, she has a moment’s hope that the Mrs. Jones waiting for her today will be a different Mrs. Jones than 90 days ago. The door opens and your provider realizes there is no way that Mrs. Jones’ visit is going to allow her to get back on schedule because the patient is in the same mental and physical condition as she was 90 days ago.

What if there was a better way? The providers at Heritage Health in Coeur d’Alene, Idaho, asked that question and have now developed a program that allows exercise to be an attainable goal for the patient. In partnership with The Salvation Army Ray and Joan Kroc Corps Community Center (“Kroc Center” to its members), Heritage Health has created a program called “Kroc Rx.” The concept is simple: Heritage Health providers are now able to prescribe exercise.

Making exercise a vital part of wellness

The Kroc Center is a state-of-the-art facility with coaches (personal trainers) whose focus is on overall wellness. They are able to work with each individual who walks through the door and create achievable fitness goals for the patient. Whether patients are jogging on the indoor track, swimming in the lap pool, or even walking in the “lazy river,” The Kroc Center provides many people opportunities for their first step into wellness. While the warm, non-threatening environment of the Kroc Center is unique, it is not unlike a typical community center or YMCA.

During their first appointment, patients are given a brief orientation to what Kroc Rx is. They sign up for a subsidized, two month membership at the Kroc Center and are given the expectation to meet weekly with their provider in a group setting for the next eight weeks. During those weekly meetings, vitals are taken and a short educational topic is covered. The remainder of the visit is spent actually exercising with the Kroc coaches.

The Heritage Health program has removed some barriers to exercise. Patients now not only have a doctor’s directive to exercise, they have a familiar face to meet them at the “gym” and are given a “warm handoff” to a qualified fitness expert who can customize a work out for them. So now when providers at Heritage Health meet with “Mrs. Jones,” they are able to not only talk about the importance of exercise, but can actually say, “I want you to exercise three times per week, and I will meet you at the gym next Tuesday at 9:00 AM to help you get started.”

How has the new program performed?

At the conclusion of the two-month membership, patients are encouraged to continue working out. Many of them continue their membership at the Kroc Center and keep meeting with their Kroc coaches on a weekly basis. Others choose different methods that better meet their needs. In just over six months, Heritage Health has enrolled over 300 patients in the program.

The success stories are inspiring. At the end of each eight-week session, Kroc Rx members are invited to a graduation celebration. They share success stories that go far beyond the original vision of the program.

Patients are reporting reduced memory loss, a more positive outlook on life, Kroc Rx friendships that have encouraged them to keep going when the times got tough, less pain, weight loss, reduction in medication requirements, and other benefits. Heritage Health providers are able to see their patients change their lives for the better, and they are inspired to find and help the next “Mrs. Jones” each and every day because they have found a better way.

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This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U58CS06846, "S/RPCAs," total award $950K, with 65 percent of program funded by nongovernmental sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.